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Stress and Infertility - The Link is There...

By Dr. David Kreiner

The old fertility legend about a couple who had failed fertility treatments adopts a baby and then all of a sudden gets pregnant is one we have all heard.

In fact, as a practicing reproductive endocrinologist over the past 34 years, I have experienced this with some of my own patients.

Those stories have led us to believe that it takes longer for women with high-stress levels to conceive. Unfortunately, there has not been much research on this. Until now, the best evidence for the benefit of stress reduction comes from the wellness center at Boston IVF where they had shown higher IVF success rates for women who were involved in their Mind Body program.

Latest Research on Stress and Fertility

A study in the ASRM journal Fertility and Sterility (the primary research outlet for our national fertility society) lends credence to a link between stress and fertility. In the study, 274 British women, ages 18 to 40 years old, were examined to determine if using fertility-monitoring devices would improve their chances of conception.

They were followed for six menstrual cycles or until they got pregnant, whichever came first. On Day Six of each cycle, saliva samples were collected. Researchers measured their levels of alpha-amylase and cortisol, two substances that reflect how the body reacts to stress.

Pregnancy rates were compared in women with the highest concentrations of alpha-amylase in their first cycle to women with the lowest levels of the stress hormone marker. It was found that over the six-month period, the group of women with the highest alpha-amylase (and hence stress) were 12 percent less likely to conceive than women with the lowest.

Cortisol levels were not associated with the women’s chances of conceiving. The alpha-amylase and cortisol reflect two different components of the stress response and don’t necessarily correlate well. Alpha-amylase reflects the “fight-or-flight” response to immediate stressors.

To confirm these findings, the research team conducted a larger and longer study of women trying to conceive. Evidence from these trials suggests that stress-reduction techniques can improve pregnancy rates in couples who use in vitro fertilization and related methods.

Applying the Findings

With such findings, it appears that patients would benefit if they enroll in various stress-reducing programs when trying to conceive. Mind-body programs, support groups, acupuncture, yoga, and massage apparently offer the greatest benefit.

As a practitioner in the field of infertility for 34 years, I endorse these adjunctive therapies for my patients undergoing treatment, with the goal of reaping the fertility-enhancing benefit of stress reduction before we submit them to multiple treatment cycles.